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Gynaecologists Catherine and Reg Hamlin left Australia in1959 on a short contract to establish a midwifery school in Ethiopia. Over 50 years later, Catherine is still there, running one of the most outstanding medical programs in the world. Through this work, thousands of women have been able to resume a normal existence after living as outcasts ... The Hospital by the River is Catherine's story.

Our normal work continued at the same pace as before, but as word of our success spread we began to see more and more women suffering from fistulas. What a tragic sight they were. Offensive to smell, dressed in rags, often completely destitute, they would sometimes walk for two or three hundred kilometres to get to Addis Ababa. One girl turned up with her mother after walking for 15 days. They had no money and nowhere to stay, so we paid for the girl's admission ourselves and allowed her mother to sleep on the floor beside her bed.

Another young woman arrived after walking for 450 kilometres. She, too was in rags and had no money. She was a difficult case, with two big holes in her bladder, through which part of the bladder had prolapsed, making it painful for her to sit down. She had endured this for ten years. Reg operated on her and after two weeks she was dry. It was an amazing transformation. Before she had been downcast and miserable; now she was reborn as a beautiful, smiling woman, with a look of joy in her eyes. We bought her a new dress to go home in, and she kept holding it up for everyone to see. When it was time for her to leave, we took her to the bus station and gave her the fare. She tried to kiss our feet and said, ‘God will reward you for all you have done for me.’

Another girl had heard about the hospital in a faraway province where they spoke a different language. Someone had written a sign asking for her to be directed to the hospital and hung it around her neck, and she eventually found her way to us.

At first Reg did the operations and I assisted him. After we had done 22 with only one failure, I felt ready to do my first. Two cousins arrived in outpatients, both dripping urine everywhere under the bench where they sat. Reg did the more difficult one, and I did the other. They recuperated lying in adjacent beds and after three weeks they were both cured.

After the success of these first cases we felt encouraged to do more. Soon the number of arrivals began to place a strain on the hospital facilities. Being desperately poor, the fistula patients were usually unable to pay for their admission. The hospital provided half a dozen free beds, but these were always full, so often we paid their fees out of our own salaries.

Even when they were admitted we would often have to cancel their operations if an emergency case came in needing urgent surgery. Accommodation became a problem, and we found that some women were being turned away by the hospital guards and porters, who would tell them there were no beds.

They would wait anyway and sometimes sleep in the hospital grounds. Reg started getting up early and searching the compound for any who had been turned away. He would tell them to sit under a certain big spreading tree near the outpatients and to wait for him there. After examining them he would gather the sad little collection and take them to the kitchen for something to eat. The hospital cooks cooperated wholeheartedly with this routine.

Reg was terribly touched by the plight of these poor women. He called them ‘the fistula pilgrims’, on account of the tremendous journeys they undertook to get to the capital. He would hear how they suffered and had been rejected, and of their struggle to get to the hospital, how they perhaps had to sell an animal or beg to raise the money, and often, as he listened to their stories, he would have tears in his eyes.

If fistula sufferers turned up at outpatients, the other women would push them to the end of the line because they were so offensive to be near. Reg would go to them and put his arms around them and say, ‘You’re the most important patient to me today. I’m going to see you first.’

If there were no beds, he would sometimes put them in the storerooms or other places that were out of sight, where there was a bit of space. Once the medical director, Dr Asrat, came to us and said, ‘The private patients are complaining about the smell of urine coming up the stairwell because you’ve got a collection of patients sleeping under the stairs to the private wing.’ But he was sympathetic and tried to find a room when he could.

These girls and women had suffered more than any woman should be called to endure. To meet only one was to be profoundly moved and called forth the utmost compassion that the human heart was capable of feeling. One girl, after making her way to us, arrived so late at night that there was no one to see her. In despair, early next morning she tried to hang herself outside the hospital gates. The guards found her in time and cut her down, and she was subsequently cured.

This excerpt was taken from Chapter nine, The Hospital by the River, Dr Catherine Hamlin with John Little, Pan Macmillan Australia.

Dr Catherine Hamlin is our next guest speaker in Brisbane and Sydney, come and hear her story, it’s going to be a very special experience.

You can purchase The Hospital by the River directly from Hamlin Fistula Ethiopia here; a must read before attending the breakfasts.